• 제목/요약/키워드: Digital Therapy

검색결과 631건 처리시간 0.024초

노인 코호트 DB를 이용한 정신과 질환 동반 노인의 생활 습관과 의료비 지출 크기의 연관성 분석 연구 (Association Between Lifestyle and Medical Expenses of Older Adults With Mental Illness: Using Korea Older Adults' Cohort Database)

  • 정지인;배수영;유은영;홍익표
    • 재활치료과학
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    • 제12권1호
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    • pp.51-63
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    • 2023
  • 목적 : 본 연구에서는 빅데이터를 통해 정신과 질환을 가진 노인의 생활 습관 행태와 의료비 지출 크기 간의 연관성을 분석하여 생활 습관의 긍정적 영향 및 중요성을 제시하고 이에 관련한 중재의 근거를 제언하고자 하였다. 연구방법 : 건강보험공단에서 제공하는 노인 코호트 데이터베이스(Database; DB)의 2014, 2015년 자료를 활용하여 이차데이터 분석을 시행하였다. 연구 목적에 따라 전체 변수 중 생활 습관 행태와 연간 의료비 지출 크기를 추출하였다. 각각의 생활 습관 행태와 연간 의료비 지출 크기 사이의 연관성은 일반선형모형(Generalized linear model)을 사용하여 분석하였다. 결과 : 선정기준에 따라 추출된 총 32,853명의 데이터가 분석에 사용되었다. 12,617명(38.40%)의 남성과 20,236명(61.60%)의 여성으로 구성되어 있었다. 생활 습관과 의료비의 연관성을 분석한 결과, 비흡연자의 경우 흡연자보다 의료비 지출이 유의하게 낮았으며(estimate = -218,255원, p = .037), 일주일 중 30분 이상 걷는 일수가 증가할수록 의료비 지출이 유의하게 감소하였다(estimate = -58,843원, p < .0001). 반면, 일주일 중 술을 마시는 일수가 감소할수록 의료비 지출이 증가하는 양상이 나타나는 결과가 도출되었다(estimate = 692,289원, p < .0001). 결론 : 본 연구는 정신과 질환을 가지고 있는 노인에게 있어 생활 습관의 행태에 따른 의료비의 변화를 분석하였다. 흡연과 운동은 의료비 지출과 음의 연관성을 나타냈으며 걷기 운동을 많이 할수록, 흡연을 하지 않을수록 의료비 지출이 감소함을 알 수 있었다. 이러한 결과는 정신과 질환을 가지고 있는 노인에게 있어 건강한 생활 습관의 중요성을 시사한다. 본 연구가 정신과 질환을 가진 노인의 신체적, 정신적 건강 증진을 위한 생활 습관 관리 프로그램의 임상적 근거로써 활용될 수 있기를 기대한다.

양성자 치료 시 방사선 작업 종사자에게 미치는 방사선 피폭에 대한 평가 (Evaluation on the Radiation Exposure of Radiation Workers in Proton Therapy)

  • 이승현;장요종;김태윤;정도형;최계숙
    • 대한방사선치료학회지
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    • 제24권2호
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    • pp.107-114
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    • 2012
  • 목 적: 기존의 광자선을 이용한 선형가속기와는 달리, 양성자 치료의 경우 물질과의 상호작용으로 발생되는 중성자를 비롯한 여러 핵종 등으로 인해 다량의 이차방사선이 생성되기 때문에 방사선 작업 종사자의 피폭은 더욱 주의 깊은 관심이 필요하다. 이에 방사선 측정 시에 널리 이용되고 있는 열형광선량계를 이용하여 방사선 작업 종사자의 피폭정도를 평가하고 이를 토대로 양성자 치료 시 방사선 피폭선량에 관한 기초 자료를 제시하고자 한다. 대상 및 방법: 본원의 양성자 치료실에서 근무한 방사선 작업 종사자를 대상으로 열형광선량계 뱃지를 이용해 피폭현황을 측정한 데이터를 비교했다. 양성자의 빔 라인 주변에서 발생하는 이차방사선의 신체부위별 피폭선량 분포를 알아보고자 신체부위(외안각, 목, 유두점, 배꼽, 등, 손목)에 가로, 세로가 각각 3 mm인 정사각형 모양의 열형광선량계를 부착하여 일일 8시간의 근무시간동안 유지하도록 하였고 총 80시간 측정하여 평균 데이터를 얻었다. 그리고 치료실 내 공간적인 방사선량의 분포를 보기 위하여 빔 사출구, PPS (Patient Positioning System), Pendant, 차폐체보관장, DIPS (Digital Image Positioning System) Console, 출입통로에 각각 열형광선랑계를 부착하고 일일 근무시간 동안의 평균 방사선량을 측정하였다. 결 과: 방사선 작업 종사자의 열형광선량계 뱃지로 측정된 피폭량을 조사한 결과 분기별 평균 0.174 mSv, 연평균 0.543 mSv로 나타났고 신체부위별로 측정한 결과에서 가장 많은 피폭량을 보인 곳은 목이였으며 가장 적은 피폭량을 보인 곳은 등(양견갑골 상각을 이은 선의 중간 지점)으로 나타났다. 작업 동선에 따른 공간적 방사선량을 알아본 결과에서는 빔 사출구 근처에서 상대적으로 높게 나타났고 거리가 멀어짐에 따라 줄어들었다. 결 론: 적은 양의 피폭일지라도 동일 장소에서 장기 근무하게 되면 피폭 누적량은 증가할 수밖에 없고 특정 부위의 누적량은 건강상의 위험을 가져다 줄 수도 있다. 그러므로 국제 방사선 방어 위원회가 권고하는 ALARA의 원칙에 따라 가능한 합리적으로 감소시킬 수 있도록 스스로 개인별 피폭관리에 철저를 기하고 피폭을 최소화시키는데 최선의 노력을 다해야 할 것이다.

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DITI로 관찰한 Bell's palsy에 미치는 수기요법의 영향에 관한 임상적 연구 (The Clinical study of Su-Gi therapy's Effects on Bell's palsy by observing of DITI)

  • 홍승철;안훈모;이재흥;하정아
    • 대한의료기공학회지
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    • 제15권1호
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    • pp.44-60
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    • 2015
  • Objective : The purpose of this study is to investigate the effect of Su-Gi therapy for Bell's palsy by using DITI. Methods : We investigated 16 patients with Bell's palsy who had visited in the H Korean medicine hospital in Gyeonggi Province from December 27th, 2010 to April 8th, 2015. The Su-Gi therapy was done by 1 times daily. We evaluated the change of them by using Digital Infrared Thermographic Imaging and Yanagihara's unweighted grading system. Results : There aren't meaningful differences in values for the meridian points in pretest and posttest which were observed by DITI of abnormal side and normal side. There are meaningful differences in values, for abnormal side and normal side of the meridian points in pretest and posttest of DITI. It was of significance that pretest Y and average ΔT of each the meridian points in the type of hyperthermia but not in the type of hypothermia. In the Correlation analysis of values of pretest and posttest, chaotic aspects of body heat distribution in the pretest change as a relatively consistent aspects in the posttest. It wasn't of significance that Correlation Analysis of Ups and downs in temperature of TE17 and Recovery speed observed by ΔY. In simple regression analysis of posttest's Y-system values against absolute ΔT by subtracting ΔTE17 from ΔST6, we didn't predict in the pretest, but could predict significantly in the posttest(Regression coefficient : -2.11) In the regression analysis result of the meridian points' ||pretest ΔT|-|posttest ΔT||, 陽白(GB14) and 頰車(ST6) are of significance (Total R-Square=0.447). But we couldn't obtain final regression analysis model. Conclusions: These results suggest that Su-Gi therapy may be effective for Bell's palsy.

Burst형과 고빈도형 경피신경전기자극치료가 실험적 동통역치와 체온에 미치는 영향 비교 (A Study Comparing the Effects of Burst Mode and High Rate Mode Transcutaneous Electrical Nerve Stimulation on Experimental Pain Threshold and Skin Temperature)

  • 김선엽;최흥식;권오윤
    • 대한물리치료과학회지
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    • 제2권2호
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    • pp.465-479
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    • 1995
  • We randomly assigned 61 healthy subjects(male 14, female 47) to compare the experimental pain threshold and skin temperature between high mode TENS and burst mode TENS. In this study, 61 subjects were divided into three groups ; high mode TENS(n=20), burst mode TENS (n=20), and control group(n=21). Experimental pain thresholds and skin temperatures were measured before, immediately after cessation of stimulation, and at 30 minutes post stimulation. Stimulation was applied to the dorsal surface of the forearm(L14, LI10). Pain thresholds were measured by chronaxie meter. Skin temperature were measured by electrical digital thermometer. The results are as follows ; 1. There were no statistical difference in the pain threshold and skin temperature at before TENS stimulation among the three groups(p>0.05). 2. The pain threshold and skin temperature in burst mode TENS group was significantly higher and longer effect than that in high mode TENS group and control group(p<0.01). 3. The pain threshold in burst mode TENS group decreased to prestimulation levels by 30 minutes poststimulation. 4. The skin temperature in burst mode TENS group decreased to prestimulation levels by 20 minutes poststimulation. 5. The skin temperature was significantly difference among three group at immediately after, and at 30 minutes poststimulation and the skin temperature in burst mode TENS group was significantely higher than that in two groups(p<0.001). 6. The increasing rate of pain threshold in high mode TENS group after immediately cassation of stimulation was 24.3%(p<0.001). 7. The increasing rate of pain threshold in burst mode TENS group after immediately cessation of stimulation was 93.5% (p<0.001).

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허리둘레변화 감지의 실시간 되먹임을 통한 의도적인 복근수축이 요추관 협착증 환자의 골반경사와 기능적 능력 그리고 신경근 조절에 미치는 영향 (The Effects of Intentional Abdominal Muscle Contraction Through Real-Time Feedback on Sensed Changes in Waist Circumference on Pain, Functional Capacity and Neuromuscular Control in Adults With Lumbar Spinal Stenosis)

  • 성재현;김창범;최종덕
    • 한국전문물리치료학회지
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    • 제25권1호
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    • pp.1-11
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    • 2018
  • Background: The continuous co-contraction of the trunk muscles through trunk stabilization exercises is important to patients with lumbar spinal stenosis (LSS). However, intentional abdominal muscle contraction (IAMC) for trunk stabilization has been used only for specific training in the treatment room. Objects: The purpose of this study was to provide feedback to adults with LSS to enable IAMC during activities of daily living (ADLs). Methods: The participants with spinal stenosis were divided into an experimental group of 15 adults and a control group of 16 adults. Electromyographic signals were measured while the subjects kept their both hands held up at $90^{\circ}$. The measured muscles were the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES). Pelvic tilt was measured using a digital pelvic inclinometer. The degree of pain was measured using the visual analogue scale (VAS) and functional capacity was measured using the Korean version of the Oswestry disability index (KODI). Results: While the experimental group showed statistically significantly higher activities in the RA, EO, and IO after the intervention compared with the control group. Pelvic tilt was significantly decreased only in the experimental group. Both the experimental and control groups exhibited statistically significant declines in the VAS and KODI (p<.01). In terms of the levels of changes, the experimental group exhibited a statistically significant larger decline only in the VAS and the pelvic tilt when compared with the control group (p<.05). Conclusions: The subjects could stabilize their trunks, and relieve their pain and dysfunctions and reduce pelvic tilt by learning abdominal muscle contraction during ADLs. The combination of therapeutic exercises and IAMC may have greater effects on patients with LSS.

남녀 대학생들의 수직착지 시 성에 따른 무릎 외반각도의 차이 (Gender Differences of Knee Valgus Angle during Vertical Drop Landing in College Students)

  • 이충휘;박소연;유원규
    • 한국전문물리치료학회지
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    • 제12권1호
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    • pp.28-35
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    • 2005
  • The purpose of this study was to determine whether gender differences existed in knee valgus kinematics in college students when performing a vertical drop landing. The hypothesis of this study was that females would demonstrate greater knee valgus motion. These differences in knee valgus motion may be indicative of decreased dynamic knee joint control in females. This study compared the initial knee valgus angle and maximum knee valgus angle at the instant of impact on vertical drop landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and two-dimensional video motion analysis software were used to analyze the kinematic data. There was significant difference in the mean knee valgus angle at initial contact landing between the two groups (Mean=$7.88^{\circ}$, SD=$4.24^{\circ}$ in males, Mean=$12.93^{\circ}$, SD=$2.89^{\circ}$ in females). The range of knee valgus angle on landing (Mean=$3.25^{\circ}$, SD=$5.72^{\circ}$ in males, Mean=$11.44^{\circ}$, SD=$6.39^{\circ}$ in females) was differed significantly (p<.05). The maximal angle of knee valgus on landing (Mean=$10.91^{\circ}$, SD=$6.89^{\circ}$ in males, Mean=$24.25^{\circ}$, SD=$6.38^{\circ}$ in females) was also differed significantly (p<.05). The females landed with a larger range of knee valgus motion than the males and this might have increased the likelihood of a knee injury. The absence of dynamic knee joint stability may be responsible for increased rates of knee injury in females. No method for accurate and practical screening and identification of athletes at increased risk of ACL injury is currently available to target those individuals that would benefit from neuromuscular training before sports participation.

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원발성 월경곤란증에 대한 침구치료 관련 무작위배정 임상시험의 체계적 고찰: 한국 문헌을 중심으로 (Acupuncture and Moxibustion for Primary Dysmenorrhea in Korean Literatures: A Systematic Review of Randomized Controlled Trials)

  • 김정완;박봉기;전종익;임윤경
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.123-130
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    • 2015
  • Objectives : Primary dysmenorrhea is one of the most common female gynecological diseases. Acupuncture and moxibustion therapy have been used to treat dysmenorrhea in Korea. The aim of this review was to examine the effectiveness of acupuncture and moxibustion therapy for primary dysmenorrhea as described in studies in Korea. Methods : A total of 8 databases were searched, with the search concluding February 15, 2015. These were the Oriental Medicine Advanced Searching Integrated System, DBpia, Korean Studies Information Service System, National Digital Science Library, Korean Traditional Knowledge Portal, Research Information Sharing Service, and Pubmed. Randomized controlled Trails(RCTs) comparing acupuncture or moxibustion therapy with non acupoints stimulation or medication were selected. Data abstraction and assessment of methodology was conducted by authors and disagreements were resolved by discussion. Results : 7 trials were included in this review, with a total of 308 participants. 4 trials reported on acupuncture, 1 trial reported on acupress by magnet, 1 trial reported on pharmacopuncture, and the other trial reported on moxibustion. Quality of methodology was low. 2 trials showed that experimental therapy was effective for pain relief compared to the controlled group. However, 5 trials did not show a significant difference in pain relief. Conclusions : Acupuncture and moxibustion therapy may reduce period pain, however, it is needed for well designed RCTs in Korea.

턱관절 장애 유무에 따른 깨물근의 두께와 턱관절 가동범위의 비대칭성 비교 (Comparison of Asymmetries on Masseter Muscle Thickness and Range of Motion in Subject With and Without Temporomandibular Disorders)

  • 이지원;양연주;원종임
    • 한국전문물리치료학회지
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    • 제26권1호
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    • pp.28-36
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    • 2019
  • Background: Temporomandibular disorder (TMD) is characterized by pain and limited range of motion in the jaw. TMD patients generally prefer to chew on the unaffected or less-affected side, and this tendency often results in asymmetries in masseter muscle thickness and range of mandibular motion. Objects: The purpose of this study was to compare the asymmetries in masseter muscle thickness and range of mandibular motion in subjects with and without temporomandibular disorders. Methods: Thirty-nine subjects were divided into two groups: A TMD group ($n_1=19$) and a control group ($n_2=20$). The jaw opening range and laterotrusion were measured using a digital vernier caliper. The masseter muscle thickness was examined in both the resting state and the maximal clenching state using ultrasonography. The absolute asymmetry indices calculated based on the laterotrusion and masseter muscle thickness of the respective right and left sides. A two-way ANOVA and a Mann-Whitney U test were used for statistical analysis. Results: No significant different was found in the masseter muscle thickness between the TMD and control group. A significant difference was found in the absolute asymmetry indices of mandibular laterotrusion between the TMD and control groups (p<.05). Furthermore, the ranges of jaw opening were significantly different between males and females (p<.05). The absolute asymmetry index values of masseter muscle thickness at rest and during maximal clenching were also significantly different between males and females (p<.05). Conclusion: These results demonstrated that the subjects with TMD had a larger degree of asymmetry in laterotrusion than those without TMD. Therefore, a physiotherapy program needs to be designed to restore normal laterotrusion capacities for TMD subjects. These results also showed that female subjects had greater absolute asymmetry indices in masseter muscle thickness than male subjects. Therefore, more training is needed to promote bilaterally balanced chewing among women.

Effects of Deep Cervical Flexor Exercise with Visual Guide on Muscle Activity and Craniovertebral Angle in Subjects with Forward Head Posture

  • Son, Kuk-kyung;Cynn, Heon-Seock;Lee, Ji-Hyun;Park, Dong-Hwan;Kim, Bo-Been
    • 대한물리의학회지
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    • 제14권2호
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    • pp.53-61
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    • 2019
  • PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

발목 불안정환자에 대한 전신음파진동기와 토구를 이용한 불안정 지지면 운동의 효과 비교 (Comparison of the Effects of Unstable Support Exercise Using Whole Body Sonic Vibrator and TOGU for Patients with Ankle Instability)

  • 김민규;양회송;정찬주;강효정;유영대
    • 대한통합의학회지
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    • 제9권4호
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    • pp.191-200
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    • 2021
  • Purpose : Chronic ankle instability can lead to problems in balance and gait due to weakness of the ankle muscles and decreased proprioceptive sensation. Balance training that stimulates proprioceptors is necessary to improve ankle stability. We aimed to compare the effects of unstable support balance exercises using whole body sonic vibration and an aero-step (TOGU) on proprioception and balance in individuals with unilateral functional ankle instability. Methods : Thirty-six participants with unilateral functional ankle instability were randomly recruited and divided into two groups (group 1 = sonic whole body vibration, group 2= TOGU). Individuals in each group participated in training for 5 weeks, 40 minutes per session, 5 times per week, and performed weight-bearing exercises in five postures on different unstable support surfaces. Proprioception was measured by digital inclinometer (Dualer IQ), and balance was measured by force platform (Biodex balance system). Results : Significant differences were observed in proprioception before and after intervention within both group (p<.05). Significant differences were also observed in the balance index before and after intervention within both groups (p<.05). Conclusion : As a result of this study, it is suggested that for individuals with ankle instability, unstable support surface training using a whole body sonic vibrator and TOGU can have a positive effects on proprioception and balance ability.